Deborah L Black, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

2394 Issued in AZ

Practice address

2016 W 16TH St
Safford, AZ 85546-4026

Phone

(928) 428-1377

Fax

(928) 348-8570

NPI assigned

Nov 8, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Deborah L Abbott Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Gila Valley Clinic PC

  dba Gila Valley Clinic

  • Rural Health Clinic/Center
  • Safford, AZ
  • NPI 1740767664
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1162944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1689744674",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2016 W 16TH ST",
            "city": "SAFFORD",
            "state": "AZ",
            "postal_code": "855464026",
            "telephone_number": "928-428-1377",
            "fax_number": "928-348-8570"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2016 W 16TH ST",
            "city": "SAFFORD",
            "state": "AZ",
            "postal_code": "855464026",
            "telephone_number": "928-428-1377",
            "fax_number": "928-348-8570"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACK",
        "first_name": "DEBORAH",
        "middle_name": "L",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-08",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "AZ",
            "license": "2394",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "636631",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DEBORAH",
            "last_name": "ABBOTT",
            "middle_name": "L",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Kevin Bedford, DO
• Jeffrey Paul Beeley, M.D.
• Mariyah Marisella Bejarano, FNP
• Jamie Biggers, NP
• Jeffrey Tyler Bingham, PHARM.D.
• Darvil Lee Boren, D.C.
• Tyler Boyack, OD
• Bradley R. Smith DMD, DHSC PLLC (Smith Orthodontics)
• Geralyn Joy Bradley, COTA/L
• Shelby Brockman

• Medical Physician Assistant in Safford, AZ
• Providers in Safford, AZ by specialty
• Medical Physician Assistant in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.